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Project

Towards a sustainable and affordable healthcare: Exploring the potential of subsidiarity in the care for complex chronic conditions.

Chronic conditions impose a significant impact on healthcare systems and expenditures. Special groups of interest are patients with complex chronic conditions (CCCs) such as congenital heart disease (CHD). These patients are growing in number. In most countries, they are predominantly cared for in tertiary care centers, yet the lost-to-follow-up rate is relatively high. Hence, strategies are needed to safeguard the accessibility and affordability of care for CCCs. Implementing subsidiarity, being the provision of clinically appropriate care at the least complex level, may be such a strategy. Generally, lower levels of care assure more continuous care at lower costs. However, to date there are no scientific criteria to decide which patients with CCCs would be most appropriately followed-up at which level of care. The overall aim of this research project is to develop and test a strategy for risk stratification, based on clinical outcomes and healthcare expenditures. Such stratification can be used for the determination of the most appropriate setting of care for patients with CCC. In this project, adults with CHD are investigated as a sample case for the broader spectrum of CCC. We will use an open, multicenter retrospective cohort design, combining clinical data from CHD programs of two university hospitals in Flanders (Belgium) and administrative databases from governmental agencies. About 13,000 patients will be included, covering 90% of the CHD population in Flanders.

Date:1 Jan 2016 →  31 Dec 2019
Keywords:complex chronic conditions, care, subsidiarity, healthcare, affordable, sustainable
Disciplines:Public health care